• What if I have a panic attack?
• What if I embarrass myself?
• What if they don’t like me?
• What if my symptoms get worse?
• What if I can’t find parking?
• What if the pain gets worse?
• What if my heart starts racing?

And on and on and on goes the brain on anxiety! When you feel anxious, the what ifs can get so loud. And they are often endless when your brain gets started. Maybe you’re nodding as you’re reading those lines. Most people who live with anxiety are no stranger to all those “What ifs.” 

And interestingly, the brain on anxiety mostly feeds you alarming “what ifs.”  Really, when is the last time you started thinking about the best-case scenario can anxiety kicked in?!  From a brain standpoint, all that worrying makes some kind of sense. You can think of it as the brain’s best attempt at preparing you for every possible worst-case scenario and keeping you safe. In other words, worrying is an attempt at keeping you safe and alive, although it's fair to say than no amount of worrying really helps in most cases! 

Interestingly, when the brain starts its cycle of negative anticipation, or worrying, these thoughts in turn can impact your physiological wellbeing. In short, thinking worrisome thoughts causes the body to gear up for danger and protect you at all costs. That’s when you might experience a racing heart, shortness of breath, muscular tension, among other symptoms of anxiety. As far as the brain is concerned, there is no significant difference between an actual threat (e.g., a tiger running full speed toward you) and an imagined threat (thinking that a tiger might attack you if you step out or worrying about giving a presentation in a room full of people). While you might sometimes notice that cascade of events, it is not uncommon for people to experience symptoms of anxiety in their body, with limited awareness of the triggering thoughts. This is especially common with panic disorder. 

Anxious thoughts are not (always) facts

In fact, very often, those thoughts aren’t based in any kind of facts or truth. And interestingly, most of those “what ifs” and all the worst-case scenario that keep you awake at night don’t end up happening. Yet, they can cause significant distress leading up to the dreaded situation or event.

Think about the last time you experienced anticipatory anxiety or were worried about an upcoming event or situation, what was the most distressing: the actual event or all the worrying leading up to it? 

Most people find that the anticipatory anxiety leading up to a dreaded event is often more distressing than the actual event. More often than not, nothing catastrophic happens, even though there might be some discomfort. “Ugh, all this worrying for this?” you might say. 

When you anticipate, your brain is free to run wild with all kinds of hypotheses and worst-case scenarios. It’s not bound by any type of facts in that moment, allowing you to think and worry about the most threatening and fearful predictions, which are arguably unlikely to come true in most cases. Once you are faced with the actual situation you were worrying about (the dreaded staff meeting, a doctor’s appointment, etc), you might notice that the anxiety is not as high as you once imagined it would. 

Anxious thoughts are just another symptom of anxiety 

One way anxiety escalates and snowballs into significant distress (sometimes culminating into a panic attack), is our tendency to cling onto our anxious thoughts and run with them. If we allow ourselves to focus on those scary predictions our brain feeds us, it’s no wonder that we feel increasingly anxious. The words that trickle in when you worry, “Heart attack”, “embarrassing”, “panic attack”, “pain”, signal to the brain that you MUST be on high alert. The brain is interpreting them as a dire signal of something catastrophic about to happen.

The brain is interpreting these anxious thoughts as facts. But here is the lie! Most often, these thoughts are NOT facts. They are most often string of (scary!) words that have no base in reality, nor are they an actual sign of impending doom. Nope. These thoughts are another symptom of your anxiety, just like your racing heart or sweaty palms might be. Let me repeat this again, anxious thoughts, often preceded by the dreaded “What if”, are just another sign of your brain on anxiety! 

What to do with anxious thoughts? Treat them as spam!

Now, what if you didn’t buy into every single thought our anxious brain fed you? What if you sometimes treated them as spam instead? Yes, you read this correctly, why not practice treating your anxious thoughts as spam or junk mail?! 

If we keep in mind that anxious thoughts are another sign of anxiety, and not based in facts, it only makes sense to not engage with them or act on them. Similarly, you would likely not open every spam that ends in your inbox or write a lengthy email back for every of the many spammy emails you receive daily. 

Over the next few days, practice treating anxious thoughts as spam. You may want to ask yourself one or a combination of the following questions:

·      Is this thought helpful or should I file it under “spam”?

·      What if I treated this thought as spam? What would happen then?

·      Can I just take note of this automatic thought and then disregard it as spam?

Isn’t it a relief to realize that we don’t have to do something about every automatic, and anxious, thought? That not every thought that crosses our mind makes sense or is valuable? 

Need help managing anxiety? I am a psychologist in Miami, Florida and I can help you deal with stress and anxiety

Wether you have received a diagnosis of an anxiety disorder (panic disorder, generalized anxiety, social anxiety disorder) or you've noticed that anxiety has recently started creeping up into your life (hello, pandemic!), therapy can help. I am an anxiety therapist and would be happy to help you manage your symptoms using a range of research-based treatments such as Cognitive Behavioral Therapy (one of the gold standard treatments for anxiety). 

I provide therapy for anxiety online throughout the states of Florida, New York, and New Jersey. And if you live in Miami or surrounding cities, in-person therapy is also an option!